MEDICARE: MS. ASHLEY CARA MALOY LMFT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	MFT001279	GA

General Provider Information

NPI Number	:	1063297927
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEY CARA MALOY LMFT

Provider Business Mailing Address
First Line	:	5002 TURTLE ROCK DR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-1448
Country	:	US
Telephone Number	:	404-933-9681
Fax Number	:

Provider Business Practice Location Address
First Line	:	5002 TURTLE ROCK DR
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30066-1448
Country	:	US
Telephone Number	:	404-933-9681
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	08/29/2023

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